Flare-ups (exacerbations)

You can reduce your risk of COPD flare-ups.

Chronic Obstructive Pulmonary Disease (COPD) is a serious lung disease that usually causes breathing to get worse over time. COPD includes chronic bronchitis, emphysema, or both.

COPD also includes symptom flare-ups. Flare-ups are episodes of new or increasing symptoms, including cough, mucus, wheezing, shortness of breath, or tightness in the chest. When you experience a COPD flare-up, you may require treatment beyond your normal medications and, in some cases, flare-ups may require hospitalization. Talk to your doctor about ways to reduce the risk of COPD exacerbations.

What is a COPD symptom flare-up?

Flare-ups are episodes when symptoms like these get worse:

Shortness of breath

Coughing

Wheezing

The presence of phlegm or mucus when you cough

A feeling of tightness in the chest

With a flare-up, you may experience:

A need for treatment beyond your normal medications

Symptoms requiring hospitalization

If you experience a flare-up, call your doctor. A flare-up may require immediate medical attention. And if your symptoms are severe, call your doctor and 911.

In addition to adding SPIRIVA HandiHaler to your treatment plan, there are things you can do to improve your overall health: if you smoke, quit, and try to identify your COPD triggers. Do everything you can to avoid respiratory illnesses or infections—talk to your doctor about the flu shot, pneumonia vaccine, and other things you can do, and how you can breathe better with SPIRIVA HandiHaler.

Do not use SPIRIVA HandiHaler if you are allergic to tiotropium, ipratropium, atropine or similar drugs, or any ingredient in this medicine.

Continued on next page

Please see additional Important Safety Information on the next page. Please see attached full Prescribing Information, including Patient Information and Instructions for Use.

IMPORTANT SAFETY INFORMATION (continued)

IMPORTANT SAFETY INFORMATION

SPIRIVA HandiHaler is not a rescue medicine and should not be used for treating sudden breathing problems. Your doctor may give you other medicine to use for sudden breathing problems.

SPIRIVA HandiHaler can cause allergic reactions. Symptoms can include raised red patches on your skin (hives), itching, rash and/or swelling of the lips, tongue or throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking the medicine and get immediate medical help.

Before using SPIRIVA HandiHaler, tell your doctor if you have a severe allergy to milk proteins.

SPIRIVA HandiHaler can cause your breathing to suddenly get worse (bronchospasm). If this happens, stop taking your medicine, use your rescue inhaler and call your doctor right away or go to the nearest emergency room.

Tell your doctor all the medicines you take, including eye drops. Ask your doctor if you are taking any anticholinergic medicines because taking them together with SPIRIVA HandiHaler can increase side effects.

SPIRIVA HandiHaler can increase the pressure in your eyes (acute narrow‐angle glaucoma), which can cause the following symptoms: eye pain, blurred vision, seeing halos or colored images along with red eyes. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

SPIRIVA HandiHaler can cause new or worsened urinary retention. Symptoms of blockage in your bladder and/or enlarged prostate may include difficulty passing urine and/or painful urination. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

Dizziness and blurred vision may occur with SPIRIVA HandiHaler. If you experience these symptoms, use caution when engaging in activities such as driving a car or operating appliances or other machines.

Do not swallow SPIRIVA capsules. The contents of the capsule should only be inhaled through your mouth using the HandiHaler device. Do not use your HandiHaler device to take other medicines.

INDICATION

Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is a prescription medicine used once daily (a maintenance medicine) to control symptoms of chronic obstructive pulmonary disease (COPD) by relaxing your airways and keeping them open. COPD includes chronic bronchitis and emphysema.

SPIRIVA HandiHaler also reduces the likelihood of flare‐ups and worsening of COPD symptoms (COPD exacerbations).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see additional Important Safety Information on the previous page. Please see full Prescribing Information, including Patient Information and Instructions for Use.

Please see additional Important Safety Information on the previous page. Please see attached full Prescribing Information, including Patient Information and Instructions for Use.

DISCLAIMER

The information provided on this site is for general information and educational purposes only. You should always consult a doctor for diagnosing and treating a health or fitness problem, and before using any drug product discussed on this site.

Following Guidelines for the Safe Use of Animals in Filmed Media, no animal was harmed in the creation of video or photographic images for this website. Click here for certification that this commercial was produced according to American Humane Association guidelines.

Youre leaving this website

You are now leaving a Boehringer Ingelheim Pharmaceuticals, Inc. site. Boehringer Ingelheim Pharmaceuticals, Inc. has not reviewed the contents of all pages and sites that may be linked to this site. Boehringer Ingelheim Pharmaceuticals, Inc. is not responsible and disclaims any liability for the content of any other page or site or for any viruses or similar harmful programs that may be present on such pages or sites. Linking to any other page or site is at your own risk.

Notice and Healthcare Provider Information

The following information is intended only for healthcare professionals licensed and practicing in the United States and is designed to be an educational aid that supplements and draws upon the professional training, experience, and knowledge of such healthcare professionals.
Do you certify that you are a healthcare professional licensed and practicing in the United States?

Do not use SPIRIVA HandiHaler if you are allergic to tiotropium, ipratropium, atropine or similar drugs, or any ingredient in this medicine.

Continued on next page

Please see additional Important Safety Information on the next page. Please see attached full Prescribing Information, including Patient Information and Instructions for Use.

IMPORTANT SAFETY INFORMATION (continued)

IMPORTANT SAFETY INFORMATION

SPIRIVA HandiHaler is not a rescue medicine and should not be used for treating sudden breathing problems. Your doctor may give you other medicine to use for sudden breathing problems.

SPIRIVA HandiHaler can cause allergic reactions. Symptoms can include raised red patches on your skin (hives), itching, rash and/or swelling of the lips, tongue or throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking the medicine and get immediate medical help.

Before using SPIRIVA HandiHaler, tell your doctor if you have a severe allergy to milk proteins.

SPIRIVA HandiHaler can cause your breathing to suddenly get worse (bronchospasm). If this happens, stop taking your medicine, use your rescue inhaler and call your doctor right away or go to the nearest emergency room.

Tell your doctor all the medicines you take, including eye drops. Ask your doctor if you are taking any anticholinergic medicines because taking them together with SPIRIVA HandiHaler can increase side effects.

SPIRIVA HandiHaler can increase the pressure in your eyes (acute narrow‐angle glaucoma), which can cause the following symptoms: eye pain, blurred vision, seeing halos or colored images along with red eyes. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

SPIRIVA HandiHaler can cause new or worsened urinary retention. Symptoms of blockage in your bladder and/or enlarged prostate may include difficulty passing urine and/or painful urination. If you have any of these symptoms, stop taking your medicine and call your doctor right away.

Dizziness and blurred vision may occur with SPIRIVA HandiHaler. If you experience these symptoms, use caution when engaging in activities such as driving a car or operating appliances or other machines.

Do not swallow SPIRIVA capsules. The contents of the capsule should only be inhaled through your mouth using the HandiHaler device. Do not use your HandiHaler device to take other medicines.

INDICATION

Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is a prescription medicine used once daily (a maintenance medicine) to control symptoms of chronic obstructive pulmonary disease (COPD) by relaxing your airways and keeping them open. COPD includes chronic bronchitis and emphysema.

SPIRIVA HandiHaler also reduces the likelihood of flare‐ups and worsening of COPD symptoms (COPD exacerbations).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see additional Important Safety Information on the previous page. Please see full Prescribing Information, including Patient Information and Instructions for Use.

Please see additional Important Safety Information on the previous page. Please see attached full Prescribing Information, including Patient Information and Instructions for Use.

DISCLAIMER

The information provided on this site is for general information and educational purposes only. You should always consult a doctor for diagnosing and treating a health or fitness problem, and before using any drug product discussed on this site.

Share this page

If you have a friend or a loved one who's having breathing difficulties, you may want to share this information with them so they can learn more about COPD.

What you'll send them is a direct link to this page. Your name will be included so that your friend or loved one will know who sent this email to them. To make sure they receive this, you'll need to fill out all of the fields below.